20040487.pdfI
DATE RECEIVED D 1,zo 104 -1 1 PERMIT EXPIRES
USE
ZON 11
CITY OF EDMONDS -6 C 61t�' N U M B E R
.JOB SUITE�Ogy
CONSTRUCTION PERMIT APPLICATION RESS
ADD
F� I) futl cl t7
OVjNE9 NAMEINAME OF BUSINESS tl( / f -
��A t- v 10 !� V/ f �? I t�A; ki, /+ ( k.>
MAILING ADDRESS
"'T* 9cl V P I
CITY ZIP TELEPHONE
'24lig
NAME
ADDREbS
L)
Cr
CITY ZIP ITELEPHONE
NAME
/_'�n r---A 1, P .
ADDRESS
1-0
CITY % zip TELEPHONE
TV �-W uAt RD (,o.1 (ol .2-41
I
ti ��' S/ I
STATE LICENSE NUMBER Er/M CHECKED BY
PROPERTY TAX ACCOUNT PARCEL NO.
1:1 NEW
RESIDENTIAL
ADDITION
COMMERCIAL
REMODEL
MULTIFAMILY
REPAIR
GRADING CYDS
DEMOLISH
El TANK
GARAGE
RETAINING WALL
CARPORT
ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
(f5 ?-r �
c�-L- k W
I (!� -
NUMBER
NUMBE OF
OF
DWELL�NG
STORIES
UNIT5,
DESCRIBE WORK TO BE DONE
HEAT SOURCE
PLAN CHECK NO:
El
PLUMBING I MECH
COMPLIANCE OR
OF USE
CHANGE
SIGN
FENCE
x FT
OTHER
FIRE SPRINKLER
FIRE ALARM
CRITICAL
AREAS
NUMBER
ils&
LOT SLOPE %
VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
V) 'APPLICANI. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
U)
w IN INTEREST. AGREES fO INDEMNIFY. DEFEND AND HOLD HARMLESS THE clry OF
_j
2 EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
cr ALI. CLAIMS FOR DAMAGES OF WHATEVER NATURF, ARISING DIRECTLY OR INDIRECRY
4
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF 1 HIS PERM11 SHAI I. NO I LIE
0 DEEMED To MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
_j
01 NOR I IMIT IN ANY WAY THE CITYS ABIL11Y TO ENFORCE ANY ORDINANCE PROVISION
I HEREBY ACKNOWLEDGE THAJ I HAVE READ THIS APPLICATION, THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL CIE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27.
S48f4ATbftf--(G 14 f�_ft�GENT)',) DATE SIGNED
PLAT NAMEISUBDIVISION NO. I LOT NO I
PUBLIC RIGH1 OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED
REQUIRED DEDICATION— Ff
MErER SIZE I LINE SIZE I NO. OF FIXTURES
L-0 NO.
1.113 FEE S
rk.SCP Approved
13
Hw Permit Hoqkjlfod
E3
Street U%o Potmil Roq'd
13
111spectirin Required
13
Sidewalk Required
E3
Ujiderground
WifIng required
13
PRV REQUIRED
YES 13 NO 0
RFMARKS
OWNER/CON TRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
RING REVIEWED BY
DATE
(5
Z
cc
LU
z
z
15
z
In
FIRE REVIEWED BY DATE Lu
W
LL
7 Y
VARIANCE OR CU SHORELINE OR AD60 I INSPECTION 13OND
RED, POSTED
OYES NO S
SEPA REVIEW SIGN AREA HEIGHT
F
COMPLETE EXT ALLOWID PROPO ALLOWED PROPOSED
EXP Koo —1
I
V
R
0
A
1
P
R
M
P
'A
S
R
'0
E
LI
P E ON
cT' LS
RE '
No
I
c
_S
ALLOWE
A , t'4 1,
_LAX
LOT COVERAGE REQUIRED SETdAcKS (Fr.) PROPOSED SETBAdKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR
z
I /'ju L /Vo C
z
PARKING LOT AREA P NINC3( R JEW B DATE
REQ'D ROV�D
3
qq 6A 110 q.
M I
REMARI 3 r-Ed 4�f�
�P/) e1471 P, P 1rA^. I T
CHECKED BY
ITYPE OF CONSTRUCTION
CQQ
C-7 �
OCCUPANT
GROUP
I/
SPECIAL INSPECTION JAREA OCCUPANT
1.3e
REQUIRED [] I I LOAD I-e-1—
YES
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RFQ'n Ej
VALUATION
$
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
CALL
FOR INSPECTION
(425)
771-0220
FEE Description FEE
State Surcharge
City Surcharge
Base Fee
Plan Chk. Deposit -_/
Co
Receipt #
Total Amt. Due
Receipt #
APPLICATION APPROVAL
I his application is riot a permit until signed by the
Building Official or his/her Deputy and Fees are paid, and
receipt is acknowledged in space provided.
FFIPlAt6 SIGNATURE DATE
WY /DAT?'
,7j . � i ) - .1 �
ATTENTION I ty%i 1333 n/�/j
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
09,03 PRESS HARD -YOU ARE MAKING 4 COPIES
ORIGINAL - FILE YELLOW - lNSPCCTC
PINK - OWNER GOLD - ASSESSOR
FA
z
0
A
0
M
--i -n
M
C
M
0
10
0 C:
--I K
X M
M Z
IC) --i
C
3:
0 -n
n;0
_.j >
3:9
M M
0 5)
0 r—
M
cf)
M 0
Z
X
z
_1
X
cf)
z
0
M
a
---------------
- - ---------- -
M.,
t V
Certt,ft,tate of ettupantp
DEPARTMENT OF BUILDINGS
PER UNIFORM BUILDING CODE SECTION 109
At: 22511 Highway 99 #1 2 Building Permit # 2004-0487
Occupancy established by this certificate: Dwelling Units: **N/A*** No. Stories: 1
B Type of Construction: VN Sprinkle= Basement: No
Maximum Occupant Load 14*** (Per UBC 1002)
Room capacity signs, when required, must remain posted at all times.
Owner of Building Welcome Market Inc. Address: 6281 Regio Ave, Buena Park, CA 90620
The Visionaire has been Inspected and approv as complying with the requirements of the 1997 Edition
of the Uniform Building Code as adopted by the City for the group and division of occupancy and the use for which -the proposed
occupancy is classified.
Issued this 271h day of Ju/y, 2004
CWEF BUILDING OFFICIAL
BY:
This certificate shall be posted in a conspicuous public area and shall not be removed. mutilated or obscured an al be maintained in legible condition at all times. Any change of occupancy or use requires a building permit and a new
Certificate of Occupancy issued by the City of Edmonds Building Official.
-k 10
(V11 (D W(1� (D, OD W(11
------------- 111
I
FINAL PROJECT APPROVAL FORM
K t:� M I Ar ra. U I
TO:.� �8�
DATE:42�0 / fe�5 41
jLJL 2 7 2004
DEVELOPMENT SERVICES CIR
CITY OF
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: (cA IU -FIRE DEPARTMENT DATE -7
PLE E SIGN
ENGINEERING DIVISION DATE
PLEASE SIGN
PLANNING DIVISION DATE
PLEASE SIGN
PROJECT
9 q -2
SITE ADDRESS
PERMIT # 04- D4V ADB# -DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine compliance with -approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERF ORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
I .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
El Copy of CORRECTION NOTICE given to owner/contractor by inpector
1 .
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fbrms:ocaprv1 3/25/04
z
0
i
0
Ri
Zi =n
U5 --i
3:
0 M
C
M
0
0 C:
M
M Z
Cn
o -n
n ;d
>
M M
0
0
M
(n
U)
Q
Z
7-1
X
z
--I
X
Cn
z
0
i
0
M
�.A
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
z
Pier/Porch .................
0
I
Retaining Wall ........... 0
171
Stab Insulation ..........
PLUMBING:
j
Underground ............. M
IT11 0
0
Rough -In ...................
0 C
Commercial Final ......
M
M Z
HEATING:
C z
GasTest .................... >
x
Gas Piping .................
0 -n
Equipment ................. n
Commercial Final ....... 3:9
ITI M
0
EXTERIOR SHEATHING
0
NAILING ............... .......... 0 M
Cf)
C/)
FRAMING ........................ Q 0
Z
FIRST FLOOR FRAMING ...
;0
INSULATION ................... --I
3:
Floor Insulation ......... >
z
Wall Insulation ...........
Ceiling Insulation ....... z
0
SHEETROCK NAILING ... --i
0
M
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
doo 97�